US under-45s struggle for insurance approval as colon cancer rates rise

As colon cancer rates are rising among people in their 20s and 30s, some adults in the US who are under 45 and experiencing worrying symptoms are struggling to get insurance coverage for colonoscopies, which can detect colon cancer.

The Affordable Care Act (ACA) requires insurance companies to cover colonoscopies for people over 45 “because it’s been recommended by the US Preventive Services Task Force”, says Caitlin Murphy, a cancer epidemiologist and professor at the University of Chicago. The ACA requires preventive screenings, including pap smears, for example, to be completely covered.

But, Murphy noted, for people “under 45, if you have symptoms like rectal bleeding, a colonoscopy would be considered a diagnostic test, and so it’s not going to be covered in the same way as a screening test would be”. She added that the cost of a diagnostic colonoscopy a given insurance plan will cover varies widely.

Dominick, a 35-year-old software engineer living in Florida, learned about the distinction between preventative and diagnostic colonoscopy the hard way. His doctor recommended a colonoscopy after he experienced bowel movement changes, stomach pain and weight loss. At first, his insurance company said it would be covered. Then, three hours before the procedure was scheduled, he got a call saying the colonoscopy wouldn’t be covered because it was considered diagnostic.

The out-of-pocket cost for Dominick’s colonoscopy was roughly $2,000, which he paid for with a credit card because he didn’t have the cash readily available. The procedure later revealed a precancerous polyp, which he had removed – he said it’s scary to think about what could have happened if he hadn’t been able to find a way to pay.

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Source: The Guardian, 23 March 2026